Pharma market access and product development
Janice Haigh, practice leader, market access Europe at Quintiles Consulting, on why pharma should be thinking about market access from the early stages of product development
By on Jun 13, 2012The pharmaceutical industry has so far not addressed the fundamental changes taking place in its market environment and is still devoting too much attention to physicians when allocating market access budgets, according to Janice Haigh, practice leader, market access Europe at Quintiles Consulting.
"If we examine market research budgets, far more is spent on understanding and exploring the needs of key opinion leaders (KOLs), specialists and general practitioners than on market access stakeholders, even when it is clear that the influence of payers and other stakeholders exceeds the influence of physicians in product uptake," she says. (For more on KOLs, see Special report: KOLs and pharma.)
From national to local
The industry's approach to market access strategies has changed dramatically in the last 10 years, and continues to evolve as the market access challenge shifts from national to local.
A decade ago, the focus was already shifting from sales strategy to national access, and in the UK this meant submissions to the National Institute of Clinical Excellence (NICE), Scottish Medicines Consortium (SMC), and All Wales Medicine Strategy Group (AWMSG). NICE was still in its infancy, having been founded in 1999, while the SMC (formed in 2001) was taking its first steps and the AWSMG (formed in 2002) was an unknown quantity.
"These newly emerging national bodies were challenging for many companies, for whom the requirements were a new way of thinking," according to Haigh. Moreover, "a few years on, companies that succeeded in these national submissions were sometimes surprised that the value arguments they presented nationally did not have much impact locally."
Drug makers discovered that cost-effectiveness is not persuasive when budgets are reduced and started to realize that they had to influence many different types of stakeholders in order to have a successful product. Now the challenges of NICE, SMC and AWMSG are the norm for a product launch and are often the first submissions in a European launch so critical to a new product's success in Europe.
"The national challenges are no less than they were—in fact, they are harder—but the industry has become more experienced at dealing with them," says Haigh. "Local challenges though are requiring deeper and more nuanced customer knowledge."
Stakeholders as customers
In fact, recognising the various market access stakeholders as customers whose needs must be understood and met, rather than barriers creating difficulties between pharma companies and their real customers, is the first step toward the goal of engaging with local payers and providers to ensure value is actually delivered in the patient setting.
Market access seems likely to challenge the traditional sales-marketing-medical triangle, which reflected the needs of the traditional customer—the physician—but new customers will need a new approach. Market access teams will need leaders totally focused on the needs of market access stakeholders and team members who are equipped to understand customer needs, respond to these needs, develop value propositions well matched to customer needs, and effectively deliver these value propositions.
At one level, these are the core skills of sales, marketing and medical, but the customers are radically different and so skills must be developed accordingly. Part of the problem is that market access is hard to define and covers a broad variety of tasks such as health economics/health technology assessment, price strategy and value message development at the regional and national level. (For more on health economics, see Health economics data and market access; for more on health technology assessments, see Market access: How to meet both marketing authorization and HTA needs and Pharma and market access: How to overcome the challenges.)
In many respects, the new approach market access is interlinked with the emerging role of key account management in the pharmaceuticals sales function, according to Haigh. "Good KAMs should be able to engage with stakeholders throughout the health service, understanding local needs whether they are clinical, economic or a mixture of both. Market access strategy will ensure that the value of the product is truly understood and can be articulated to all stakeholders," she says.
Implementation needs to ensure that the value messages are delivered in the right way for the right audience, and often that is the job of the KAM. (For more on KAM, see Key account management: A special report.)
The payer perspective
In pharma as much as any other industry, established companies tend to be risk averse and so they continue to invest in the tried and trusted approaches. When they are ready to change, often they react more slowly and have a higher cost base. Haigh believes drug makers should be thinking about market access strategy from the early stages of a new product's development.
In those early stages, taking the payer perspective into account is critical in order to understand unmet need from their perspective. "It's important to understand what is needed for which patients and how that might be valued," according to Haigh. "Later in development, the payer perspective on the types of evidence collected—which outcomes, which resources, over what period of time—needs to be understood so claims can be justified."
As a minimum, local market access efforts should start around two years before launch, ensuring that the customer's environment is fully understood, including all the stakeholders in the design and delivery of treatment, how treatment is paid for (for example, tariffs and codes) and how budgets are set.
For more on market access, join the sector’s other key players at Market Access Europe in October and Market Access Canada on November 21-22 in Toronto.
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